Title: Evaluation of the Endometrium in Postmenopausal Bleeding by Transvaginal Sonography
Authors: Purva Mahesh Agrawal, Dipali S Kadam, Avinash Dhok, Kushal A Tayade, Gurnihal Singh, Karan Singh Bajwa
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.223
Abstract
Postmenopausal Bleeding (PMB) refers to any vaginal Bleeding in Postmenopausal woman other than expected cyclic Bleeding that occurs with sequential hormone replacement therapy.PMB is generally attributed to endometrial etiology. Transvaginal Sonography (TVS) is primary Imaging modality for the evaluation of the endometrium. The purpose is to evaluate the endometrium in Post-menopausal Bleeding patients by TVS and correlating the findings with histopathology. This study design was a cross-sectional observational study conducted in department of radiodiagnosis at our institute. Sample Size–100 patients with post-menopausal bleeding above the age of 40 years were included. Consent was taken before subjecting them into the study. A detailed history was taken. The patients were then subjected for TVS. Endometrial thickness of 4 mm was used as a cut-off point. Ultrasound data were compared with histopathology. Maximum number of patients were in age group of 40-60 years (82 %). Maximum women(31%) with Post-menopausal Bleeding have parity 3 followed by parity 2. 47 % of women with Post-menopausal Bleeding were in the first 5 years of menopause. Mean of the atrophic Endometrium was 2.5 ± 1 mm and 8.7 ± 4.3 in those with hyperplasia and in endometrial carcinoma, mean of 17.7 ± 10 mm. Every Post-menopausal women with Bleeding should undergo TVS evaluation as it is primary Imaging for the endometrium. In patients with PMB, screening should be done annually in the first 5 years of menopause.
Keywords: Endometrium, menopause, postmenopausal bleeding, transvaginal sonography.